Homeopathy: Real Medicine or Modern Day Voodoo?

Before I start talking I want to remind you that good scientific research does not take sides, it does not have self-interests, nor does it have feelings; science’s only goal is to show what is true and what is not. With that said let’s start talking about whether or not homeopathy works. When people mention the word homeopathy sometimes they are referring to something entirely different. Homeopathy does not refer to all “natural” treatments, nor does it refer to all herbal remedies. In our discussion it will be very important to clearly identify what homeopathy is.

Homeopathy is a medical practice that seeks to treat patients with diluted substances that are given orally. For those of you that are not aware dilution means to make a solution thinner or weaker by adding water. Homeopathy is founded upon two main philosophies. The first is that “like heals like” and the second is “ultra-dilution”. “Like heals like” refers to the belief that a substance that causes a symptom given in a diluted form will help treat that same symptom. So if your rash is caused by poison ivy, if you give poison ivy in a diluted form it will make the rash go away.  “Ultra-dilution” states that the more diluted a substance gets the more potent it becomes. This increased potency is aided by a specific method of shaking the solution called “succession”. These practices are what I will be referring to when I discuss homeopathy.

When you consider any medical practice it is good to discuss if the ideas behind it are plausible. “Like heals like”, does not make any sense when considering what we know today.  If you are suffering from arsenic poisoning it would not be logical to take more of it, even if it is in a diluted form. The idea of “ultra-dilution” seems a little silly to me. Think of it this way, if I have some chocolate syrup and a bag of milk, the way to make it chocolatier is to add more syrup (making it more potent). However under the principle of “ultra-dilution” my milk should get chocolatier with less syrup. That is not the case in the real world. With all that being said, even if we don’t understand why it works, it could still help. If you can show that it helps it doesn’t matter if you don’t know how it works. This is the case with many anesthetics; we know that they do reduce pain but we are not totally sure how they work. So now let’s discuss the efficacy of homeopathy.

Similar to acupuncture there is a great deal of conflicting evidence out there. In fact there are scientific journals out there called homeopathy, in which the scientists are looking for evidence that supports it. So this means once again we need to look critically at the literature. We need to look at the experiments that have been done and determine if they are done correctly. If you do this you will find that many of the studies in support of homeopathy have major methodological flaws. This is why properly conducted meta-analysis are so necessary. If properly done they can look at all the studies out there and filter out the bad ones to determine what the truth is. The UK Science and Technology committee did just that. They compiled a report that looked at all the scientific evidence out there and came to the conclusion that it simply does not work.

There is so much evidence out there showing that homeopathy does not work and yet the industry continues to grow.  In 2012 it was estimated that the homeopathy industry in the US is worth 339.9 million dollars and that the annual growth is 7.2%. In 2006 it was estimated that 4.8 million people in the US used homeopathy and that number is only expected to grow. This is sad, so many people literally wasting their money on treatments that are totally ineffective.

Homeopathy does not work; it’s as simple as that.

References

1.   House of Commons Science and Technology Committee. Evidence Check 2: Homeopathy

http://www.publications.parliament.uk/pa/cm200910/cmselect/cmsctech/45/45.pdf

2.      Shang A, Huwiler-MÃ1⁄4ntener K, Nartey L, JÃ1⁄4ni P, al e. Are the clinical effects of homoeopathy placebo effects? comparative study of placebo-controlled trials of homoeopathy and allopathy. The Lancet. 2005;366(9487):726-32.

3.      Ernst E. Homeopathy: What does the "best" evidence tell us? Med J Aust. 2010;192(8):458-460.

The Placebo Effect

Most of us have heard about the placebo effect but I would wager that many people don’t fully understand what that means. To help explain it I will describe an experiment. So let’s say I am conducting an experiment to test the effect of aspirin on back pain. To determine if this actually helps I am going to split up my subjects two groups. One group will receive aspirin pills and the other will be given sugar pills. Considering past experiments I know that the sugar pill will have no effect on back pain. To demonstrate the placebo effect we are going to focus on the placebo group and ignore the aspirin group. After giving each patient the sugar pill most of them may say that they feel better. They indicate that there back pain has greatly diminished or has stopped altogether. Does this mean that sugar pills help will back pain? No probably not, in fact we would probably get the same results if we had given them water pills. So the question is; why do they feel better? All these patients thought they were getting aspirin so psychologically they expected to feel better. Their perception of pain has changed because they thought they were getting the real treatment when in fact they were getting a sugar pill. This happens all the time in experiments and it has been well documented¹. What is important to remember however is that these patients physical condition has not changed. Whatever caused their pain in the first place is still there. The sugar pills have not cured anything but have made the person perceive their pain differently. The placebo effect cannot cure cancer, heart failure, kidney disease or anything for that matter. All it can do is make people think they feel better when in fact nothing has changed.

Sometimes the placebo effect is used as evidence that people can “will” themselves to good health. Considering what I have discussed that is obviously not the case. This understanding will become pivotal in future discussion because it shows that placebo treatments are a deception and should never be promoted as real medicine. Tricking someone into thinking they feel better is morally wrong.  

References

1. de Craen ,A.J., Kaptchuk TJ, Tijssen JG, Kleijnen J. Placebos and placebo effects in medicine: Historical overview. J R Soc Med. 1999;92(10):511-515. 
http://search.proquest.com/docview/69443209?accountid=11233.

Is being an authority important in evidence based medicine?

I was talking with a friend today and he brought up a valid point that I would like to address. He mentioned the idea of authority, so what exactly constitutes someone as an authority on a medical issue. Does a person need a B.Sc, a Master's, a PHD or an MD to be an authority on a medical issue? Am I an authority on medical issues? No I am not. I am in the early stages of my education so even if those titles mattered in our discussions I would not qualify. I would argue that no matter what your title is, it is not good enough to endorse a therapy without evidence to back it up. Randomized control trials are what’s needed to claim a therapy helps; not a title like PHD. All are equal in the eyes of science (at least in theory), so if you can prove it then that's good enough. I don't what anyone to just take my word for it, please read my references and then evaluate the evidence. I am simply providing you with information and then the rest is up to you. 

As an aside I am not saying that you shouldn't trust your doctor. They have spent a decade learning what the medical literature says and applying it. There job is to tell you what science says, if you ever have questions they should be able to direct you to the original research. 

What is considered credible information?

So what is a good source of information about medicine?  In medicine the definitive answers come from Randomized Control Trials. These are experiments in which the treatment is compared to a previous treatment or a placebo group. This helps us figure out if it really works better than what we already have or if it works at all. Often when you read news papers they try to summarize experiments and make them exciting to read. More often then not however they mess something up. They report things incorrectly or oversimplify the results. I mean think about it, these are people you spent their careers in journalism, they may not have the expertise to properly explain the results. This means the in the end you have to read the original research. I know that most will not do that so I would like to suggest a few good sources of info.

Health Canada's Website

http://www.hc-sc.gc.ca/index-eng.php

Journal of the American Medical Association (they often publish articles that are easy to read and summarize the results of previous experiments)

http://jama.jamanetwork.com/journal.aspx

Try using Google Scholar, sometimes reading the abstracts of experiments isn't so bad

http://scholar.google.ca/

Review Articles, this is where a scientist takes all the information previously collected and summorizes what we know. They are much easier to read than the original research.

Wikipedia, I have found that on many issues Wiki provides a very good source of info. Although you need to remember that it can very easily be wrong so take what it says causally.

Now this is not a full list but only some suggestions. Just remember to always consider how reliable your information is. If you want to be an expert on a medical issue you need to read the original research. 

Wes

Introduction

Hello,

My name is Wesley Rose and before I begin my blog I thought it would be appropriate to introduce myself. I am a graduate of University of Guelph and my B.Sc. is in Biomedical science. I am currently perusing a Master’s at Guelph and I love what I do. My area of interest is medicine and that is what I will focus on.

I have become very concerned at the amount of misinformation that exists in regard to medicine. The internet has provided a great way to quickly share information but that has also lead to bad information being spread. 

My goal is to provide an unbiased approach to evaluating medical treatments. Either they work or they don’t, and that’s what I would like to determine.. I am not telling you my opinion of what I think works or doesn't work I am telling you what is true. Science’s goal is to determine what is true, it does not take sides and it does not care what you think. It only cares about what is true and what’s not. I will be as cold as science in that sense, neither your or my beliefs matter on these issues, all that matters is what is true. Everything I say will be backed up with properly conducted experiments that show us what is true. Over thousands of years we have determined as a species that properly conducted experiments show us how the world works meaning that in medicine they are the gold standard in determining if a treatment works.

I have found that there is a disconnect between the scientific community and the general public. I think that somewhere down the line scientists forget how to talk to everyone else. They use big words and confusing terminology that is lost on many people (me included). My hope is that I will be able to communicate to you in a simple manner what the scientific community already knows.

I hope you find my blog informative.

Wes